Atenolol and Metoprolol. A Comparison of Their Excretion into Human Breast Milk

Kulas, Josip; Lunell, Nils‐Olov; Rosing, Ulf; Steen, B; Rane, Anders

doi:10.3109/00016348409157126

Cited by 38 publications

(23 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Comparison with data for other [3-blockers indicates a higher milk/blood ratios (2.5-10) for acebutolol and a similar value (1.6-4.5) for atenolol, metoprolol, oxprenoloi and propranolol (Boutroy et al 1986;Kulas et al 1984;Liedholm et al 1981;Lundborg et al 1981;SandstrOm and Regardh 1980;Sioufi et al 1984;Thorley et al 1983;White et al 1984).…”

Section: Discussionmentioning

confidence: 97%

Placental transfer and perinatal pharmacokinetics of betaxolol

Morselli¹,

Boutroy

Bianchetti³

et al. 1990

Eur J Clin Pharmacol

View full text Add to dashboard Cite

Betaxolol levels in blood were monitored in the perinatal period in 28 pregnant hypertensive women and in their babies. In the mothers betaxolol concentrations at delivery ranged from less than 1 to 115 ng.ml-1 after doses of 10 to 40 mg.day-1. The apparent blood half-life was 15.6 to 22.1 h mean (19 h). Umbilical cord levels indicated a rapid equilibrium between fetal and maternal units (ratio 0.93) within few hours after dosing. Milk betaxolol concentrations, measured in few cases, exceeded those in blood by a factor of 3. Amniotic fluid concentrations were similar to those observed in maternal venous blood and umbilical cord blood. In neonates, the blood betaxolol half-life ranged from 14.8 to 38.5 h, with a definite trend towards a negative correlation with gestational age. A 11-61% rise in the betaxolol concentration was observed in 64% of the neonates during the first 12 h of extrauterine life. The data indicate that betaxolol kinetics is not altered in pregnant women and they stress the need for careful and prolonged (72-96 h) intensive monitoring of neonates born to hypertensive mothers treated with beta-blocking agents.

show abstract

Section: Discussionmentioning

confidence: 97%

Placental transfer and perinatal pharmacokinetics of betaxolol

Morselli¹,

Boutroy

Bianchetti³

et al. 1990

Eur J Clin Pharmacol

View full text Add to dashboard Cite

show abstract

“…101 As infant plasma concentrations are negligible, use during breastfeeding is not expected to pose a risk to the infant. 115,116 Although symptoms caused by β-blockade (such as brady cardia and hypoglycaemia) have not previously been reported following exposure to propranolol or metoprolol via milk, some authors nevertheless recommend that exposed infants should be closely observed for these signs. 117 Even though such effects perhaps could be an issue in preterm infants or newborns, we consider it unlikely that any such pharmacological effect would arise in a breastfed infant.…”

Section: Ergot Alkaloidsmentioning

confidence: 96%

Pharmacological treatment of migraine during pregnancy and breastfeeding

et al. 2015

View full text Add to dashboard Cite

Migraine affects up to 25% of women of reproductive age. In the majority of these women, migraine improves progressively during pregnancy, but symptoms generally recur shortly after delivery. As suboptimally treated migraine in pregnancy could have negative consequences for both mother and fetus, the primary aim of clinicians should be to provide optimal treatment according to stage of pregnancy, while minimising possible risks related to drug therapy. Nonpharmacological approaches are always first-line treatment, and should also be used to complement any required drug treatment. Paracetamol is the preferred drug for acute treatment throughout pregnancy. If paracetamol is not sufficiently effective, sporadic use of sumatriptan can be considered. NSAIDs such as ibuprofen can also be used under certain circumstances, though their intake in the first and third trimesters is associated with specific risks and contraindications. Preventive treatment should only be considered in the most severe cases. In women contemplating pregnancy, counselling is essential to promote a safe and healthy pregnancy and postpartum period for the mother and child, and should involve a dialogue addressing maternal concerns and expectations about drug treatment. This Review summarizes current evidence of the safety of the most common antimigraine medications during pregnancy and breastfeeding, and provides treatment recommendations for use in clinical practice.

show abstract

“…However, the extent of such an increase is variable among the various drugs: it ap pears quite high with OH-metoprolol, mod erate for diacetolol, and minimal for betaxo- [32].…”

Section: Commentsmentioning

confidence: 99%

“…Effective concentrations capable of re ducing heart rate and arterial blood pressure have been noticed in about 35% of the stud ied population 24-36 h after birth [30], Milk atenolol levels, in the cases tested so far, are considerably higher (up to 5-fold) than those present in maternal plasma and the risk of effective intake by breast-fed neo nates does exist [31][32][33]. It should also be mentioned that in those cases where the treatment to the mother was stopped 24 h before delivery, no atenolol could be mea sured in the umbilical cord or in the new born [27,28].…”

Section: Atenololmentioning

confidence: 99%

See 1 more Smart Citation

Pharmacokinetics of Antihypertensive Drugs in the Neonatal Period

Morselli¹,

Boutroy²,

Bianchetti³

et al. 1989

Dev Pharmacol Ther

View full text Add to dashboard Cite

A consistent body of evidence indicates that in the preterm and full-term newborn drug disposition is reduced when compared to that of infants, grown-up children, and adults. Newborns are rarely treated directly with antihypertensive agents; however they can be exposed to the action of various antihypertensive drugs in utero and during their first week of extrauterine life in the case of hypertensive mothers treated through pregnancy. In such cases, the persistence of the antihypertensive agent during the first days of life may have important consequences on neonatal haemodynamics and on the function and the maturation of vital organs such as lungs and kidneys. The available information on the placental transfer and neonatal pharmacokinetics of a-methyldopa, clonidine, acébutolol, atenolol, betaxolol, metoprolol, propanolol, oxprenolol, and latetalol, are reviewed. Each product has its own pharmacokinetic characteristics which should influence, depending on the clinical situation, the therapeutic choice. In the presence of comparable efficacy, preference should be given to compounds with high bioavailability, eliminated mainly via metabolic degradation, with no active metabolites. In all cases, treatment should be discontinued 8-12 h before delivery.

show abstract

Atenolol and Metoprolol. A Comparison of Their Excretion into Human Breast Milk

Cited by 38 publications

References 11 publications

Placental transfer and perinatal pharmacokinetics of betaxolol

Placental transfer and perinatal pharmacokinetics of betaxolol

Pharmacological treatment of migraine during pregnancy and breastfeeding

Pharmacokinetics of Antihypertensive Drugs in the Neonatal Period

Contact Info

Product

Resources

About